4.6 Review

Cellular and mitochondrial mechanisms of atrial fibrillation

Journal

BASIC RESEARCH IN CARDIOLOGY
Volume 115, Issue 6, Pages -

Publisher

SPRINGER HEIDELBERG
DOI: 10.1007/s00395-020-00827-7

Keywords

Atrial fibrillation; Mitochondria; Electrophysiology; Oxidative stress; Calcium; Atrial cardiomyopathy

Funding

  1. DZHK
  2. Deutsche Forschungsgemeinschaft (DFG) [Ma 2528/7-1, SFB 894, TRR-219, EXC 2067/1-390729940, VO 1568/3-1, IRTG1816, SFB1002]
  3. Else-Kroner-Fresenius Foundation [EKFS 2016_A20]
  4. German Ministry of Education and Research (BMBF) [01EO1504]
  5. Projekt DEAL

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The molecular mechanisms underlying atrial fibrillation (AF), the most common form of arrhythmia, are poorly understood and therefore target-specific treatment options remain an unmet clinical need. Excitation-contraction coupling in cardiac myocytes requires high amounts of adenosine triphosphate (ATP), which is replenished by oxidative phosphorylation in mitochondria. Calcium (Ca2+) is a key regulator of mitochondrial function by stimulating the Krebs cycle, which produces nicotinamide adenine dinucleotide for ATP production at the electron transport chain and nicotinamide adenine dinucleotide phosphate for the elimination of reactive oxygen species (ROS). While it is now well established that mitochondrial dysfunction plays an important role in the pathophysiology of heart failure, this has been less investigated in atrial myocytes in AF. Considering the high prevalence of AF, investigating the role of mitochondria in this disease may guide the path towards new therapeutic targets. In this review, we discuss the importance of mitochondrial Ca2+ handling in regulating ATP production and mitochondrial ROS emission and how alterations, particularly in these aspects of mitochondrial activity, may play a role in AF. In addition to describing research advances, we highlight areas in which further studies are required to elucidate the role of mitochondria in AF.

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